Korean Circ J.  2010 Oct;40(10):530-535. 10.4070/kcj.2010.40.10.530.

Three Cases of Non-Surgical Treatment of Stent Loss During Percutaneous Coronary Intervention

• Shim BJ
• Lee JM
• Lee SJ
• Kim SS
• Lee DH
• Shin WS
• Yu JH
• Gil SH

• KMID: 1826143
• DOI: http://doi.org/10.4070/kcj.2010.40.10.530

Abstract

Percutaneous coronary intervention with stenting is widely used for ischemic heart disease. Because stent loss, which occurs rarely during the procedure, might have dire consequences, such as bleeding, stent embolism, acute myocardial infarction, emergency coronary artery bypass graft, and death, appropriate treatment is needed as soon as stent loss occurs. We report three cases of stent loss which were successfully treated with three different non-surgical methods.

Keyword

Percutaneous transluminal augoplasty; Stents

MeSH Terms

Coronary Artery Bypass
Embolism
Emergencies
Hemorrhage
Myocardial Infarction
Myocardial Ischemia
Percutaneous Coronary Intervention
Stents
Transplants

Figure

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  Fig. 1 Case 1. A: left coronary angiography showed chronic total occlusion of the proximal left anterior descending artery (LAD) and severe, calcified stenosis of the proximal left circumflex artery. B: the lost stent {Taxus™ 3.0/20 mm (arrow)} is seen in the proximal LAD. C: the snare (arrow) was tightened around the stent. D: photography of the removed Taxus™ stent and snare.

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  Fig. 2 Case 2. A: left coronary angiography showed severe, calcified stenosis of the proximal left anterior descending artery (LAD). B: the unexpanded lost stent {Xience V™ 3.0/15 mm stent (arrow)} is seen in the proximal LAD. C: the lost stent at the original site is depicted with an arrow; a 2.0/15 mm Ikazuchi™ balloon was placed into the stent and dilatation was performed. D: the lost stent was successfully dilated with a residual 30% stenosis.

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  Fig. 3 Case 3 (Initial CAG). A: left coronary angiography showed chronic total occlusion of the mid-left anterior descending artery (LAD) and 70% stenosis proximally, and 90% stenosis of the distal left circumflex artery (LCX). B-D: the unexpanded lost stent (Endeavor™ 3.0/24 mm stent, arrow) is seen in the mid-LAD. C and D: the proximal-to-distal LCX underwent stenting with a PICO™ 3.0/24 mm stent and an Endeavor™ 2.75/18 mm stent, respectively. CAG: coronary angiography.

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  Fig. 4 Case 3 (Follow up CAG 1 month). A: a 90% stenosis and the lost stent are apparent in the proximal LAD. B: a guide wire was passed into the lesion and stent. C: using a 3.0/15 mm Kaneka RX™ balloon dilatation was performed to 6 atm. Using an Endeavor™ 3.5/15 mm stent, the lost stent was compressed and then inserted. D: final Coronary angiography showed recovery of the hemodynamic profile. CAG: coronary angiography.

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